A panorama of the medicolegal aspects of suicide assessments: integrating multiple vantage points in improving quality, safety, and risk management

Abstract

Epidemiological trends in global suicides have been of serious concern in the last decade. The burden of higher expectations in the assessment of suicidal behaviors on mental health professionals is mounting. However, the suicidal risk assessment has many evolving and moving parts, and is one of the most heavily researched fields in psychiatry. Although it is clear from current empirical research that suicide cannot accurately be predicted, the standard of care from regulatory bodies and professional organizations dictates the use of established measures and following consensus guidelines. However, the legal system has different parameters to assess for the deviation from these standards and views it from a different vantage point. Therefore, it is imperative to know these critical multifaceted panoramas of suicide assessment. Considering the gaps within suicide risk assessment tools, we propose that appropriate documentation and thorough treatment planning are key to navigating the complex medicolegal risks. These approaches are useful for risk management and improve clinical outcomes, quality of care, and overall patient safety.

Predictors of Defensive Practices among Italian Psychiatrists: Additional Findings from a National Survey

“…The questionnaire was based on instruments previously validated in similar studies [16,17]. The investigated domains included questions about treating suicidal (1), violent (2), pregnant (3), and elderly patients (4); initiating or changing drug treatment (5); the impact of PoG on the therapeutic relationship and decisions regarding involuntary hospitalization (6); and clinical risk management training and the relevant Italian legislation (7), specifically the so-called 'Gelli-Bianco' Law.…”

“…Psychiatry is considered to be among the low-risk specialties [4], with less than 1% of all medical malpractice claims paid [5]. However, despite the low incidence, there are concerns regarding the elevated likelihood of disciplinary actions compared to other specialties [6] and of criminal lawsuits in cases of patient suicide or involvement in violent actions [7].…”